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ACUTE EXPOSURE INFORMATION

Formaldehyde cyanohydrin may be toxic by eye, skin, inhalation, and oral exposure. It is an irritant and is converted to cyanide in the body.

Death may occur within minutes or may be delayed in onset.

The clinical presentation of the patient depends upon the extent of and time since exposure. Initially the patient may experience flushing, tachycardia, tachypnea, headache, and dizziness. This then may progress to agitation, stupor, coma, apnea, generalized seizures, bradycardia, hypotension, pulmonary edema, and death.

The absence of a rapidly deteriorating course does not exclude the diagnosis of cyanide poisoning. Patients have survived lethal ingestions with only supportive care.

With exposure to nitrile compounds such as formaldehyde cyanohydrin, the onset of cyanide poisoning may be delayed. Cyanide exposure may produce death within minutes. Lesser exposures may produce nausea, vomiting, palpitations, confusion, hyperventilation, anxiety, and vertigo. Severe hypoxic signs in the absence of cyanosis should suggest the diagnosis.

Cyanosis is generally a late finding and does not occur until the stage of circulatory collapse and apnea.